Those who have ventured “below the line” on articles regarding homeopathy will perhaps have come across “Dr” Nancy Malik, a prolific pro-homeopathy zealot who can be typified by her chronic inability to read and assess the articles she is touting as showing that her beloved modality is anything other than water.

In the not too distance past, Ms Malik had a “knol” – a Google hosted blog where she collected all the scientific papers that she thought showed homeopathy worked. I assessed that here.

(Spoilers: there’s nothing in it.)

Google pulled the plug on Knol, and Ms Malik migrated her site to WordPress.
A few months ago, she got the site HONcode certified. HONcode is an independent organisation that promotes and certifies websites that they deem as giving reliable healthcare information. Obviously, I found it odd that HONcode (who seek to abide by the tenets evidence based medicine) would certify a homeopathy site. I raised this with them, and encouraged others to do so. After a brief e-mail conversation, HONcode wisely chose to suspend Ms Malik’s certification, pending a review. The HONcode logo on her site and the verification link (supplied by HONcode) changed to reflect this – now showing a ‘men at work’ sign with a red “ReExam” warning.

Both myself and Alan Henness asked Ms Malik when she might be altering her website to take this into account. This morning, after several weeks gentle prompting, we got a reply…

Her website HAD been changed!

Or had it? The HONcode logo still has the red “ReExam” logo, but when one clicked on the verify link… Something magical happened!

EDIT: I’ve added some links & an image of the genuine HONcode certificate.

UPDATE: Alan Henness was the first of us to illicit a response from HONcode, who appear to confirm that they have rescinded their certification for Ms Malik’s site. Perhaps we might speculate that her sudden action on this issue (after 6 weeks of nought but silence on the matter) might have been precipitated by HONcode informing her of their decision?

I don’t claim to have a particularly comprehensive knowledge of the medical/scientific evidence surrounding the time during pregnancy beyond which abortion is not safe/feasible/practical, but I have never seen any evidence that claims to back a 12 week limit. Certainly, it is clear in the 2006-7 parliament report into scientific developments relating to abortion[PDF] that no evidence appears to have been presented that supports a 12 week limit. Perhaps there is some new evidence I have not seen?

I would be very interested indeed to see the evidence upon which Jeremy Hunt has based his decision. So interested, in fact, that I have submitted a freedom of information request to the department of health so that I might see this evidence. Without this evidence I cannot possibly make an informed decision on this matter, so it is imperative that the evidence be made available for everyone to read for themselves.

I would also echo calls made on twitter that “There should be a legal requirement, any time an MP says their view is backed by evidence, they must publish said evidence.”

The department of health have until the 2nd of November 2012 to reply to my FOI request. Any and all responses I get will be blogged.

EDIT – 19/10/2012
Today Jeremy Hunt appeared on the Radio 4 Today program. He was asked by Justin Webb about where he got the evidence for his stance on reducing the legal limit for abortion from 24 weeks to 12 weeks, and on his views on the efficacy (or otherwise) of homeopathy. Hunt does a superb answer of answering almost any other question he can think of. He was pointedly asked what his evidence was, and where he got it from. He did not answer the question. You can listen to a clip of the interview here. As of today, I have had an acknowledgement from the DoH about my FOI request, but nothing further. They have until the 02/11/2012 to reply.

“glass fragments present during the manufacture” and ” in the Clikpak Assembly”

“one out of every six bottles did not receive the dose of active homeopathic drug solution due to the wobbling and vibration of the bottle assembly during filling of the active ingredient. The active ingredient was instead seen dripping down the outside of the vial assembly. Your firm lacked controls to ensure that the active ingredient is delivered to every bottle.”

“The dosing process has not been validated appropriately. Specifically, your surrogate validation study, “Medication of un-medicated pillules with (b)(4),” visually demonstrates the variability of the amount of (b)(4) for the pillules in one vial. Your firm lacks control of the variation for the amount of the active ingredient in the pillules.”

“Your firm does not have an established written program to calibrate/qualify the Perkin Elmer Clarus gas chromatograph (GC) at suitable intervals.”

” Your firm did not calibrate and qualify the Jasco high performance liquid chromatography (HPLC) instrumentation adequately, in that there is no periodic qualification or evaluation of the pump, oven, injector, or detector. The “Use and Calibration of HPLC” procedure does not include criteria to define adequate calibration of the instrument.”

Basically – they don’t manufacture their remedies in a controlled and consistent manner, and they cannot monitor this because it’s homeopathy, there’s nothing to monitor they don’t maintain the equipment for doing so in the correct and proper fashion.

If this was a real drug company, the implications could be disastrous. If one in six packs of antibiotics was duff, you can bet that we’d hear about that and there would be huge fines levied all round.

One wonders if users of the duff batches of remedies noticed the lack of “powerful gentle natural effective” homeopathic active ingredient, and promptly complained to Nelsons about this?

This failure to adhere to best practice has landed Nelsons on the FDA red list [Link – scroll down to United Kingdom] – “Detention Without Physical Examination of Drugs From Firms Which Have Not Met Drug GMPs” – it seems (from my reading of this notice) that Nelsons cannot export their goods to the US, and if US customers officials discover people bringing Nelsons products into the US they are to confiscate the goods. This will clearly have a negative impact on their US exports, and Nelsons are clearly rather proud of their export success [Link].

I don’t know about the legal ramification about being on the red list, but I cannot find mention of a US based manufacturing facility. Indeed, the Nelsons website states that

Our range of products meet the appropriate UK and global regulatory and licensing requirements, and are made in our Wimbledon manufacturing facility which operates to Good Manufacturing Practice (GMP) and rigorous procedures. [Link]

Clearly the FDA might have something to say about the “Good Manufacturing Practice (GMP) and rigorous procedures”.

However, as Nelsons homeopathic products are manufactured in Wimbledon, UK, it follows that any Nelsons products sold in the US must have been imported. I don’t imagine that the FDA red notice acts retrospectively, but obviously, as we are repeatedly told that “homeopathy is exceedingly popular and therefore it must work” :) – one imagines that US stocks of Nelsons goods will soon run dry. I invite you to keep your eye on this page [link – warning – may cause nausea and temporary blindness ;)] to see when then this occurs.

Obviously, such a high profile and conscientious homeopath will ensure that the information on his website will remain up-to-date and entirely responsible. Moreover, given the concerns about the quality of Nelsons goods, one wonders if said homeopath will stop supplying them, to avoid the stigma of being tainted by Nelsons new-earned reputation for poor quality goods.

…there is no greater folly than to be very inquisitive and laborious to find out the causes of such a phenomenon as never had an existence, and therefore men ought to be cautious and to be fully assured of the truth of the effect before they venture to explicate the cause

The displaying of supposed witchcraft by John Webster, 1677.

Relevant to real scientists, and to those quacks and charlatans seeking a mechanism of action for medicines that do not yet have a proven effect.

Prof Edzard Ernst has said that homeopathy should not be offered on the NHS.

Correct.

In a nutshell, it is an implausible modality which lacks robust scientific evidence to demonstrate:
A) that it works
B) how it works.

Application of Occam’s razor (still a valid tool in scientific deduction) suggests that it is nothing more than a highly ritualised placebo (see posts passim).

However, this poll in ‘Teh Grauniad’ has been worded (either accidentally or not) in a way to polarise opinion and push any undecided liberals (small ‘l’ – them who generally dislike banning of anything – myself included) in the direction of the ‘no’ button, and add to the popular fallacy/delusion amongst the altmed community that OMG THE SKEPTIKZ ARR FACISTS.

The wording Prof Ernst, should not be offered, is a much better way of posing the question, as it sticks to the heart of the matter without invoking any sort of totalitarianism amongst those that seek to only offer evidence-based treatment on the NHS.

I strongly believe that homeopathy should not be offered on the NHS, because it has not been conclusively demonstrated to work any better than a placebo. A cash-strapped NHS (whatever may become of it) should not be spending taxpayer’s money on stuff that does not work.

If people want to waste their own money on some of the most expensive sugar imaginable, that’s their own business.

Besides, this poll is nothing more than a “who can spread the word around their community fastest” competition, and irrespective if the outcome, is just an appeal to popularity.

I know times are hard in the HE sector, but UoM is an esteemed centre of learning, not some dodgy two-bit end-of-the-pier show.

At least the events page at the Chancellors Hotel has the sense to state that:

“Theatre demonstrations are to be deemed for entertainment purposes only.”

Still, given that there is zero/zilch/nada/none credible evidence that there is “life after death”, or that certain people can communicate with the dead, should an academic institution with the credibility of UoM give oxygen to this brand of charlatanry?

A few quack websites (e.g. such as the one discussed here) have lept on the terrible events surrounding the earthquake and subsequent tsunami in Japan to make a fast buck off the backs of scared and vulnerable people.

This one is no better than the others, but it couches and prefaces the descent to batshittery with some sensible advice about emergency planning and what have you.

See if you can spot the odd one out in this list:

Having a preparedness plan should put in place now, not when you need to go to the store and purchase goods that the rest of the population is wanting also. Stores will sell out within hours in an emergency. Things to have on hand are;

Homeopathic remedies stored in a lead lined film bag with information on how to use them.

Personal documents in a handy place and organized

A family plan that everyone knows – where to meet, who to call. etc.

Did you spot it?

The page then talks sensibly about some of the effects and symptoms of radiation sickness before plunging head first back into the woo, suggesting lots of homeopathic remedies for cancer. And fear of cancer.

Cadmium Metallicum – For stomach cancer. Violent vomiting, loss of appetite and emaciation. Bright red bloody diarrhea. Blood changes, anemia, problems in the intestinal tract. Fatigue and lassitude like in influenza. Dull ache all over. Concentration difficult. Fear of Cancer. Indifference, does not want to see people anymore. Irritability alternating with deep depression.

Cadmium Sulphuricum – Similar to Arsenicum Album. Cancer of the stomach. Persistent vomiting. Black vomit. Chief complaints are the stomach and breathing. Chilliness and cold even next to the fire. Restless. Gray complexion. Nause, retching with burning and cutting pains. Worse from motion.

Cadmium Iodatum – Very similar to Cad Met but warmer. The Iodine component brings aggravation from heat or extreme cold. A distinctive mental trait is hatred and a high degree of self pity.

Strontium Carbonicum – Effects the bones. Shock after surgery or loss of blood. Pains fleeting, can hardly tell where they have come from, felt in the marrow of the bones. Pains appear and disappear gradually also. Violent involuntary starts. Burning, gnawing pains. Great prostration. Anguish as from guilt. Angry, tendency to fly into a rage. Depression.

It should go without saying that NONE of these remedies have any proven efficacy what-so-ever. The ‘potency’ is not mentioned, but it is worth repeating that there is no known mechanism of action for remedies that are diluted beyond 12C, i.e. those that do not contain any molecules of the original substance.

Another sickening example of people pushing unproven quack remedies on scared and vulnerable people, much like the ‘homeopaths without borders’ incursion into Haiti, following the earthquake there.